It's an injury that can change careers and sometimes even end them, but thanks to modern medicine and evolving techniques, Major League Baseball pitchers are bouncing back from injuries faster than ever.
The sounds of baseball are echoing in the Gulf Coast once again, with full squad workouts commencing this week. Pitchers are taking the mound, but so are the fears of injury.
"It's part of the game, unfortunately," said Estero grad and Boston Red Sox pitcher Josh Winckowski. "[You] just kind of try to do your best to avoid it."
For pitchers in today's game, velocity and power is everything. But studies show that overuse and max-effort training is contributing to a rise in those injuries. Sports medicine surgeon Dr. Josh Dines agrees.
"There's such a preponderance placed on the radar gun and throwing hard and getting hitters to swing and miss," said Dines. "They've got to throw really hard. And that leads to the ligament tearing."
Major League Baseball released a comprehensive report in December 2024. It revealed that in recent seasons, the spike in injuries has occurred during spring training.
"I think the mentality of things have changed," said Winckowski. "You feel the need to show up to spring training more ready than maybe you have in the past."
"There's probably some self-imposed stuff where some of these players are trying to make teams," said Dines. "They've got to bring their A-game. During the season, somebody on one of the professional teams, if they have the slightest bit of symptoms, we're going to shut them down and tell them to rest and be hyper-protective of it. Whereas if you're maybe on the 40-man roster, but you're trying to get a slot, you're not gonna start complaining about injuries if you think you can push through.
"And I think that may be kind of a risk factor for injury. It's kind of the nature of the business. But I think these are all athletes who are competitive. If they think they can do it and go out there, they're going to push."
According to that same report, reconstructive ligament surgeries on pitchers' elbows -- or Tommy John surgeries -- increased drastically. In 2010, 83 major league players underwent UCL surgery and in 2024, 240 players had it done. But as the number of players getting surgeries increases, so do the number of ways doctors can treat them.
"It's becoming much more popular to do what's called a ligament repair," said Dines. "So in certain situations, depending on how the ligament tears, you could actually sew it back to the bone and not have to do that reconstruction where you're taking a graft from somewhere else. It's great because it's a much quicker recovery. It's 6 or 8 months as opposed to 14 months. There's [fewer] complications. So for a lot of reasons it's a lot better."
When asked if there are ways for teams to try and avoid their pitchers getting to the point of surgery, Dines said, "There's basically a sensor that one can wear on their elbow that's the size of two quarters stacked up that tracks the amount of load you're putting on the elbow so we can see if somebody's spending too much load on it."
Dines says those machines and equipment can also be used for recovery after surgery.
"It seemed like actually undergoing it was almost like a death sentence," said Boston Red Sox pitcher Garrett Crochet. "Now you see guys bouncing back. You see that could return to play and be the same player, if not better. There's a lot of guys in the league that you could look to who have, you know, continue to make a name for themselves and continue to go on and have great careers."
Big-name pitchers like Garrett Crochet, FGCU alum Chris Sale and Cape Coral grad Shane McClanahan have all suffered season-ending injuries, but have made it back as starters again.
"We're seeing the advancements in analytics and risk prevention or injury prevention," said Shana McClanahan, Tampa Bay Rays pitcher. "We have a great team of medical staff here that are on the cutting edge of doing anything they can to help us stay on the field. They do everything for us. They do such a great job of making sure we're in the right position, the right mindset, right spot physically. The game's ever changing and I think we're going to change with it. So I think it's for the better."
After winning the 2024 Cy Young Award and being named MLB Comeback Player of the Year, Atlanta Braves pitcher Sale emphasizes the importance of consistency and preparation in staying healthy.
"I honestly just tried to replicate last offseason as much as I possibly could," said Sale. "To be able to kind of show up here in the same way I was last year. So, hoping to just kind of run it back and do the same thing."
"It's not easy," said McClanahan, "But it gets easier. You, you just learn how to accept it and just put the next foot forward."